Tuesday, 8 Sep 2020

Written Answers Nos. 1386-1405

Hospital Acquired Infections

Questions (1386)

John Lahart

Question:

1386. Deputy John Lahart asked the Minister for Health the incidences of MRSA in hospitals for 2019 and to date in 2020 since the outbreak of Covid-19. [22515/20]

Written answers

Minister for Health

This question has been referred to the Health Service Executive (HSE) for attention and direct reply to the Deputy as it concerns operational matters.

Question No. 1387 answered with Question No. 980.

Ministerial Advisers

Questions (1388)

Catherine Murphy

Question:

1388. Deputy Catherine Murphy asked the Minister for Health if he will provide a schedule of advisers, special advisers and seconded civil servants working in his Department appointed and or recruited and or in an acting capacity; the roles and responsibilities attributed to each; and the salary scale for each role in tabular form. [22531/20]

Written answers

Minister for Health

The Department of Public Expenditure and Reform has issued guidelines to each Government Department setting out the arrangements for the staffing of Ministerial Offices. The appointment of Special Advisers is subject to section 11 of the Public Service Management Act 1997.

The appointment of individual Special Advisers is a matter for each Government Minister subject to the terms set out in the aforementioned guidelines, although the appointments are also subject to formal Government approval. At this stage, no Special Advisers have been formally appointed to my Department by the Government.

However, the Deputy may wish to note that I have assigned one person to work with me as Special Adviser and another person to work with me as a Press and Communications Adviser and these persons will be formally appointed by the Government in the near future.

The Minister for Public Expenditure and Reform must be notified of the rate of salary to be paid in all cases for Special Advisers; These rates will then be published on the website of the Department of Public Expenditure and Reform.

Medical Cards

Questions (1389)

Paul McAuliffe

Question:

1389. Deputy Paul McAuliffe asked the Minister for Health the status of a medical card for a person (details supplied). [22541/20]

Written answers

Minister for Health

As this is a service matter it has been sent to the Health Service Executive for direct reply to the Deputy.

Question No. 1390 answered with Question No. 980.

Covid-19 Pandemic

Questions (1391)

Thomas Gould

Question:

1391. Deputy Thomas Gould asked the Minister for Health if updated guidelines will be issued for front-line workers who are deemed very high risk to facilitate their return to work in view of the economic impact of their continued isolation. [22549/20]

Written answers

Minister for Health

The HSE has produced a range of guidance notes for COVID-19, including guidance for healthcare and non-healthcare settings.

"Guidance on Fitness for Work of Healthcare Workers in the Higher Risk Categories" is available at:

https://www.hse.ie/eng/staff/workplace-health-and-wellbeing-unit/covid-19-guidance/guidance-on-fitness-for-work-of-healthcare-workers-in-the-higher-risk-categories.pdf

Medical Cards

Questions (1392)

Neale Richmond

Question:

1392. Deputy Neale Richmond asked the Minister for Health if the decision to request further information will be reviewed view of the difficult circumstances in the case of a person (details supplied); and if he will make a statement on the matter. [22553/20]

Written answers

Minister for Health

As this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.

Covid-19 Pandemic Supports

Questions (1393)

Rose Conway-Walsh

Question:

1393. Deputy Rose Conway-Walsh asked the Minister for Health the provisions in place for staff who are pregnant and cannot return to work due to having to use excessive sanitisers and disinfectants; if a Covid-19 payment will be introduced to cover loss of earnings; and if he will make a statement on the matter. [22560/20]

Written answers

Minister for Health

Eligibility for COVID-19 payment and illness benefit while absent from work (for whatever reason) is a matter for Department of Employment Affairs and Social Protection.

Hospital Data

Questions (1394, 1395, 1396)

Carol Nolan

Question:

1394. Deputy Carol Nolan asked the Minister for Health the steps being taken to increase the number of base adult critical care beds within the public health system; and if he will make a statement on the matter. [22561/20]

Carol Nolan

Question:

1395. Deputy Carol Nolan asked the Minister for Health the reason there was an increase of just 19 adult critical care beds within the public health system from March 2020 to 20 August 2020 (details supplied); and if he will make a statement on the matter. [22562/20]

Carol Nolan

Question:

1396. Deputy Carol Nolan asked the Minister for Health if the critical care capacity within the public health system is sufficient to admit up to 15% of hospitalised cases to critical care as recommended by the European Centre for Disease Prevention and Control (ECDC) guidance 25/3/2020; if his attention has been drawn to the fact that the same EDC guidance has identified Ireland as being at an extremely high risk of saturation of its baseline intensive care unit capacity; and if he will make a statement on the matter. [22563/20]

Written answers

Minister for Health

I propose to take Questions Nos. 1394 to 1396, inclusive, together.

The Health Service Capacity Review 2018 recommended that Ireland’s critical care capacity be increased to 430 beds by 2031. In early 2020, baseline permanent adult critical care capacity in Ireland was reported by the National Office of Clinical Audit (NOCA) to be 255 beds. Funding for a further 40 adult critical care beds, and two paediatric critical care beds, was provided as part of the response to Covid-19 in March 2020. Surge ICU capacity supports the provision of critical care as required.

My Department and the HSE have been engaging in regard to critical care capacity requirements in the public hospital system and consideration is ongoing.

Statutory Instruments

Questions (1397)

Joe O'Brien

Question:

1397. Deputy Joe O'Brien asked the Minister for Health when a statutory instrument will be issued under the Health Services (Drug Payment Scheme) Regulations 2017 to give effect to the planned reduction of the drugs payment scheme threshold to €114; and if he will make a statement on the matter. [22566/20]

Written answers

Minister for Health

As part of Budget 2020, the previous Government announced two measures intended to reduce the cost of medicines:

- GMS prescription charges would be reduced by €0.50c for all medical card holders. The charge would be reduced by €0.50c to €1 per item for the over 70s and by €0.50c to €1.50 for persons under70. The maximum monthly charge would also be reduced to €10 and €15 respectively.

- The monthly threshold of €124 for the Drug Payment Scheme (DPS) would be reduced by €10 to €114 per household.

The funding of these measures was predicated on the achievement of corresponding savings in the health budget in 2020. It has not been possible to achieve these savings to date and therefore I am not in a position at present to progress the changes to prescription charges. I will keep this matter under review in the light of the funding available to the health service in 2020 and 2021.

Commencement of Legislation

Questions (1398)

Joe O'Brien

Question:

1398. Deputy Joe O'Brien asked the Minister for Health when section 2 of the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 is to be commenced; and if he will make a statement on the matter. [22567/20]

Written answers

Minister for Health

The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020 was enacted on 2nd August 2020. This Act provides, amongst other things, for the necessary legislative amendments to the Health Act 1970 (as amended) to increase the weekly gross medical card income limits for those aged 70 and over to €550 per week for a single person (currently €500 per week) and to €1,050 per week for a couple (currently €900 per week). The Government is finalising decisions on the associated funding for this measure and the implementation date for the commencement of this provision.

Medicinal Products

Questions (1399)

John Lahart

Question:

1399. Deputy John Lahart asked the Minister for Health if consideration is being given to changes to the medicinal products regulations or other regulations to ensure efficient distribution of the flu vaccine and a potential Covid-19 vaccine similar to regulations being considered in the UK (details supplied); and the details of changes being considered. [22615/20]

Written answers

Minister for Health

There are no plans to amend legislation regarding the distribution of the flu vaccine.

In relation to a potential COVID-19 vaccine, the National Public Health Emergency Team (NPHET) recommended that a COVID-19 Immunisation Strategy Group, chaired by the Department of Health, and informed by the National Immunisation Advisory Committee (NIAC), be convened. The inaugural meeting of the Group took place on the 26 August 2020. The purpose of the Group is to advise on and assist in the development of national policy relating to COVID-19 vaccines. Any necessary legislative changes will be considered in this context.

Cancer Services

Questions (1400)

Brendan Griffin

Question:

1400. Deputy Brendan Griffin asked the Minister for Health when the three national cancer screening programmes will be up and running to full capacity (details supplied). [22617/20]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Covid-19 Tests

Questions (1401)

Michael Fitzmaurice

Question:

1401. Deputy Michael Fitzmaurice asked the Minister for Health the number of Covid-19 tests being carried out on a daily basis by county in the weeks ending 23 and 30 August 2020; and if he will make a statement on the matter. [22682/20]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Tests

Questions (1402)

Michael Fitzmaurice

Question:

1402. Deputy Michael Fitzmaurice asked the Minister for Health the number of Covid-19 tests each facility carried out on a daily basis by county in the weeks ending 23 and 30 August 2020; and if he will make a statement on the matter. [22683/20]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Tests

Questions (1403)

Michael Fitzmaurice

Question:

1403. Deputy Michael Fitzmaurice asked the Minister for Health the capacity of laboratories that carry out the Covid-19 analysis; and if he will make a statement on the matter. [22684/20]

Written answers

Minister for Health

As this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Mental Health Services

Questions (1404)

Martin Browne

Question:

1404. Deputy Martin Browne asked the Minister for Health if his attention has been drawn to the way in which accident and emergency units are unsuitable for the presentation of persons in a mental health crisis situation; his views on the need for mental health crisis presentation areas in each hospital that would be separate to the general accident and emergency area; the progress being made on a proposal for a crisis room at the accident and emergency department of South Tipperary General Hospital; his plans to investigate the roll-out of separate mental health waiting areas in each acute hospital nationally; and if he will make a statement on the matter. [22688/20]

Written answers

Minister of State at the Department of Health

The Deputy will be aware that I have visited Clonmel in relation to Mental Health on three occasions since becoming Minister, the latest being 28 August when I visited South Tipperary General Hospital to see the arrangements in place for mental health patients attending its Emergency Department (ED).

I had a most useful and enlightening discussion with representatives of the Executive Management Team and some of the Clinical Leads. I was given a comprehensive tour of the hospital to get an overview of all major services there, including those for mental health patients needing to attend ED where often serious or life-threatening physical care is required.

The provision of care to mental health patients attending EDs nationally is in line with agreed norms for such care settings. It reflects also the widely agreed mental health policies A Vision for Change and Sharing the Vision, thus helping to reduce stigma and improve integrated care for mental health patients. These objectives are clearly being realised at South Tipperary General Hospital, including within the ED, and the operational practice there is in line with HSE and HIQA requirements for such patients.

All mental health patients attending the ED are triaged in accordance with assessed clinical need, with the objective of referring them as soon as possible to the HSE Mental Health service once they are discharged from ED.

The South Tipperary General Hospital ED has a 24-hour Mental Health Nurse Liaison service for mental health patients. I spoke at length with the Mental Health Liaison Nurse on duty who is one of 3 that delivers a 24-hour service 7 days a week. There are two existing rooms within this ED, dedicated for mental health patients. Bearing in mind all the circumstances, which I detailed further in my letter of 1 September to local public representatives in Tipperary and which I asked to be relayed to local voluntary groups, there are no plans to introduce the type of separate care pathways suggested by the Deputy. I am satisfied that arrangements in the ED at this hospital, and nationally, are suitable and offer high quality and safe services to mental health patients requiring emergency physical care.

Mental Health Policy

Questions (1405)

Martin Browne

Question:

1405. Deputy Martin Browne asked the Minister for Health if his attention has been drawn to instances in which persons with mental health issues can discharge themselves in an unobserved and unaccompanied manner; if his attention has been further drawn the dangers this can present to the persons concerned; his views on whether this is an issue that needs to be addressed; and if he will make a statement on the matter. [22689/20]

Written answers

Minister of State at the Department of Health

Any voluntary patient has the right to leave hospital at any time and/or consent to or refuse treatment. Detention of any person without consent is a serious matter that it can only happen in accordance with the law – in this case, the Mental Health Act 2001. This important Act ensures that the best interests of patients are central to any decision taken.

Where a person is in the community, the process of involuntary detention under the 2001 Act is a three- step process. The first step requires an application, (which can be made by a spouse or relative, an authorised officer, a member of An Garda Síochána or any other person, subject to conditions set out in section 9(2) of the Act), followed by a recommendation by a GP that the person is suffering from a mental disorder and would benefit from a period of treatment in hospital. The third step is the requirement that the consultant psychiatrist, following an assessment, diagnoses the person as suffering from a mental disorder within the meaning of section 3 of the Act, and authorises the involuntary admission of the person. Upon admission of a patient on an involuntary basis, a second examination by an independent consultant psychiatrist takes place to affirm or refuse the order.

However, where a person has already been admitted on a voluntary basis and indicates that they wish to leave, then sections 23 and 24 of the 2001 Act allow the treating Consultant Psychiatrist to involuntarily admit the person, provided another Consultant Psychiatrist agrees that the person is suffering from a mental disorder within the meaning of section 3 of the Act.

It is also important to mention that in addition to the requirement to follow clear admission statutory procedures, the Act also gives every detained person the right to automatically have their involuntary admission reviewed. This means that such admissions must be reviewed by a Mental Health Tribunal made up of three independently appointed persons. If the Mental Health Tribunal believes that the procedures for involuntary admission followed the law and that the person is suffering from a mental disorder, their decision will be to affirm the admission or renewal order. If, however, the Mental Health Tribunal decides that the criteria for detention are not fulfilled, the Tribunal will direct that the person be discharged. A lawyer is also appointed by the Mental Health Commission to represent the detained person, free of charge, at the Mental Health Tribunal hearing. The person may continue to stay in hospital as a voluntary patient, if that is their choice and further treatment is indicated. However, if they do not wish to remain, they must be discharged.

Under Section 28 of the Act, the consultant psychiatrist responsible for the care and treatment of an involuntary person must ensure that they are not inappropriately discharged and that they are detained only for so long as is reasonably necessary for their proper care and treatment.

I should also add that it is important to point out that it is only people who have been diagnosed as having a mental disorder that can be detained under the 2001 Act. The Act specifically prohibits the detention of persons by reason only of the fact that they are suffering from a personality disorder, are socially deviant or are addicted to drugs or intoxicants.

In addition to the present safeguards in the 2001 Act, I am pleased to say that a draft bill is being drawn up to amend the Act based on the recommendations of an Expert Group Review of the Act. The intention of the changes proposed will be to strengthen the safeguards of persons liable to detention under the Act and ensure that the Act fully respects the autonomy of individuals who have capacity to make their own decisions regarding treatment.

The review has further taken into account developments in terms of Ireland's international obligations, such as the ratification of the Convention on the Rights of Persons with Disabilities, as well as recent legislative changes in Ireland, including the Assisted Decision-Making (Capacity) Act 2015, and the proposed Protection of Liberty safeguards. These changes and others, when included in revised mental health legislation, will further improve the protections available to mental health service users. The Department is currently consulting with the Mental Health Commission and the HSE on the draft heads, and hopes to finalise the draft heads in the by the end of 2020, depending on the timely provision of input from stakeholders and legal advice.